What works to enable more organisations to support new parents?

Tove Andersson explains what we learned from scaling up Baby Steps, our evidence-based perinatal education programme  

Baby with a toyBaby Steps is a group work programme that helps vulnerable parents prepare for parenthood. Parents take part in six pre-natal and three post-natal sessions, where they learn about a range of topics. We’ve evaluated Baby Steps and found it can help improve parent-child relationships and decrease parental anxiety and depression.

Baby Steps was one of the first services that we scaled up – this means we support other organisations to deliver the programme so we can reach more families in the UK. Our Scale-up Unit provides implementation support, training and resources to make sure other agencies are able to deliver Baby Steps effectively.

We began the scale-up process by rolling out Baby Steps to six ‘early adopter’ organisations, and we carried out an evaluation of this initial phase. I’m going to explain what we learned from the evaluation, and how we addressed some of the challenges that other organisations were experiencing.

What helped our early adopters make implementation a success?

Overall, our evaluation found that the scale-up of Baby Steps has gone well. The programme is valued and it’s seen to be helping families.

Factors that helped pave the way for a successful implementation of the programme include:

by getting them to come along to the training or holding targeted briefings.

with senior management representation to cement multi-agency buy-in.

who is dedicated to the programme to provide support to practitioners and promote fidelity to the Baby Steps model.

who are given administrative support and protected hours for Baby Steps work.

for Baby Steps facilitators. This helps improve the quality of the programme and ensure fidelity to the model.

by building good working relationships with referring bodies and continuing to be proactive about promoting the programme to referrers.

What challenges did our early adopters experience?

Our evaluation found that the early adopter organisations experienced some challenges to implementing Baby Steps.

We addressed each of these to improve the way we support organisations to deliver the programme in the future.

Baby Steps was perceived to be a time intensive programme for a number of reasons. For example two practitioners are required to deliver the programme together and they need to take part in a number of reflective supervision sessions. This has an impact on the other work that practitioners can carry out.

We produced detailed implementation guidance and a resource pack for organisations that are interested in delivering Baby Steps. This includes tools to help them map the resource requirements of the programme and estimate the implementation costs involved.


One of the strengths of Baby Steps is its multi-agency approach – it’s designed to be delivered by two practitioners from different backgrounds in health and social care. However, cross-agency co-delivery could be complicated for a number of reasons, including anxiety about different working styles, logistics of cross-agency working and perceptions about the hierarchy of different professions.

This challenge tended to diminish once delivery had started, because facilitators saw the strength of the cross-agency model. However, we recognise the need to emphasise the advantages of co-delivery and address any initial anxiety.


Cross-agency infrastructures such as information recording systems were sometimes challenging to negotiate or missing.

The guidance and resource pack we provide for organisations considering delivering Baby Steps includes information about the infrastructure that’s needed for cross-agency delivery. This helps organisations plan and put the necessary infrastructure in place.

In the future we’ll recommend that organisations set up a multi-agency steering group to oversee implementation and ensure that systems are in place. Our Scale-up Unit will attend these steering group meetings in the early stages of scaling up the service.


Logistical challenges, such as finding appropriate venues and transport issues.

The guidance and resource pack we provide includes advice and support around venues, transport and timings of groups.


Difficulties meeting the terms of our licence agreement, for example finding it difficult to have a practitioner from health and a practitioner from social care present at sessions or experiencing challenges providing reflective supervision for practitioners.

Our Scale-up Unit will look at flexible options and solutions to these challenges with each partner organisation. They will agree a tailored local approach whilst making sure this doesn’t compromise the Baby Steps model.


Staff turnover at all levels of the organisation means that extra costs are incurred for training new staff members.

We’re going to trial a ‘training for trainers’ model. This will enable our partner organisations to have their own trainers and minimise on-going training costs.

Our readiness assessment for potential new partners will also address organisational stability.


Funding challenges, for example if the programme sits across agencies that are separately funded or if it’s commissioned as a pilot rather than core business.

Our guidance and resource pack includes advice about evaluation to help organisations demonstrate the outcomes and benefits of Baby Steps in their area. This is helpful when securing ongoing funding.

Next steps

We’ve expanded the scale-up of Baby Steps since the implementation evaluation was completed and 8 organisations are currently licenced to deliver the programme. We’ll be using the findings of the evaluation to inform the way we support other organisations to implement the service and help make things go as smoothly as possible.

We’ll also be using what we’ve learnt about what works to implement our services in other organisations more widely, to inform our approach for scaling up other services.

Read more about our evaluation of the way we supported our early adopters to deliver Baby Steps in the full evaluation report.

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